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Ciprofloxacin iontophoresis for aminoglycoside-resistant pseudomonal keratitis
J A Hobden1, J J Reidy, R J O'Callaghan
1Department of Microbiology, Louisiana State University Medical Center, New Orleans.
Abstract:
Studies using ciprofloxacin for the therapy of experimental aminoglycoside-resistant keratitis caused by Pseudomonas aeruginosa were conducted using transcorneal iontophoresis as the drug-delivery system. Corneas infected with P. aeruginosa ATCC 27853/pMG6 were treated 22 hours postinfection with ciprofloxacin delivered by iontophoresis (0.8 mA X 10 min), mock iontophoresis (eyecup with no current), or frequently applied topical drops. Iontophoresis of 10 mg/ml or 25 mg/ml of ciprofloxacin significantly reduced the number of viable bacteria per cornea by more than 5 log units compared with untreated controls (P less than 0.0001). Five hours after the initiation of treatment, mock iontophoresis (10 mg/ml or 25 mg/ml) or 11 applications of topical ciproflaxicin drops (7.5 mg/ml) decreased the viable bacteria relative to the untreated controls by 5 log units (P less than 0.0001). One treatment with an eyecup was as effective as 11 treatments with topical drops (P greater than 0.75). One hour after treatment with iontophoresis or mock iontophoresis of 10 mg/ml of ciprofloxacin, aqueous humor concentrations were 83.75 +/- 8.85 micrograms/ml and 24.87 +/- 4.0 micrograms/ml (mean +/- standard error of the mean), respectively. One hour after the last of five applications of 7.5 mg/ml of ciprofloxacin (every 15 min for 1 hr) the aqueous humor concentration was 4.2 +/- 1.14 micrograms/ml. These results show the value of ciprofloxacin in treating aminoglycoside-resistant infections caused by P. aeruginosa and suggest that ciprofloxacin can be efficiently delivered by iontophoresis.
Insights
Transcorneal iontophoresis effectively delivered ciprofloxacin to treat experimental Pseudomonas aeruginosa keratitis. This method significantly reduced bacterial load, offering a promising alternative for aminoglycoside-resistant infections.
Area of Science:
- Ophthalmology
- Microbiology
- Pharmacology
Background:
- Aminoglycoside-resistant Pseudomonas aeruginosa poses a significant challenge in treating bacterial keratitis.
- Traditional topical antibiotic delivery can be limited in achieving effective intraocular drug concentrations.
Purpose of the Study:
- To evaluate the efficacy of ciprofloxacin delivered via transcorneal iontophoresis for experimental Pseudomonas aeruginosa keratitis.
- To compare the effectiveness of iontophoretic delivery with conventional topical drops and mock iontophoresis.
Main Methods:
- Experimental keratitis was induced in corneas using P. aeruginosa.
- Treatment groups included ciprofloxacin delivered by iontophoresis (0.8 mA x 10 min), mock iontophoresis, and frequent topical drops.
- Bacterial load and aqueous humor concentrations were quantified post-treatment.
Main Results:
- Iontophoretic delivery of ciprofloxacin significantly reduced viable bacteria by over 5 log units compared to controls.
- Mock iontophoresis and 11 topical drop applications also achieved a 5 log unit reduction.
- Aqueous humor concentrations of ciprofloxacin were substantially higher with iontophoresis (83.75 µg/ml) versus topical drops (4.2 µg/ml).
Conclusions:
- Ciprofloxacin is effective in treating aminoglycoside-resistant P. aeruginosa keratitis.
- Transcorneal iontophoresis is an efficient drug delivery system for achieving high ciprofloxacin concentrations in the aqueous humor.
- Iontophoresis presents a viable alternative to frequent topical applications for ocular infections.